Exploring the Life-Saving Potential of Naloxone: A Systematic Review and Descriptive Meta-Analysis of Take Home Naloxone (THN) Programmes for Opioid Users

Andrew McAuley, Lorna Aucott, Catriona Matheson

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22 Citations (Scopus)
5 Downloads (Pure)

Abstract

Background
The epidemic of drug-related mortality continues to endure. The most common cause of death associated with drugs is overdose and opioids are consistently the substances most prominently involved. As well as efforts to control the availability of illicit drugs and increase engagement in treatment services, the use of naloxone for peer administration has increasingly been championed as a mechanism for addressing the DRD epidemic. Despite increasing adoption and use of take-home naloxone (THN) as a primary response to DRD internationally the evidence base remains limited.
Methods
A systematic review and descriptive meta-analysis of the international THN literature was undertaken to determine an effect size for THN programmes. For each study, a Proportion of Use (PoU) was calculated using the number of ‘peer administered uses’ and the ‘total number of participant/clients’ trained and supplied with naloxone with a specific focus on people who use drugs (PWUD). This was constrained to a three month period as the lowest common denominator. As a percentage this gives the three month rate of use (per 100 participants).
Results
From twenty-five identified THN evaluations, nine studies allowed a PoU to be determined. Overall, the model shows a range of 5.2 to 13.1 (point estimate 9.2) naloxone uses every three months for every 100 PWUD trained.
Conclusion
Our model estimates that around 9% of naloxone kits distributed are likely to be used for peer administration within the first three months of supply for every 100 PWUD trained. Future evaluations should directly compare different training structures to test relative effectiveness and use a series of fixed time periods (3, 6 and 12 months) to determine whether time since training affects rate of naloxone use.

Original languageEnglish
Pages (from-to)1183-1188
Number of pages6
JournalInternational Journal of Drug Policy
Volume26
Issue number12
Early online date1 Oct 2015
DOIs
Publication statusPublished - Dec 2015

Fingerprint

Naloxone
Opioid Analgesics
Meta-Analysis
Pharmaceutical Preparations
Drug Overdose
Street Drugs
Cause of Death
Mortality

Keywords

  • Take-home naloxone
  • drugs
  • opioid
  • mortality
  • overdose

Cite this

Exploring the Life-Saving Potential of Naloxone : A Systematic Review and Descriptive Meta-Analysis of Take Home Naloxone (THN) Programmes for Opioid Users. / McAuley, Andrew ; Aucott, Lorna; Matheson, Catriona.

In: International Journal of Drug Policy, Vol. 26, No. 12, 12.2015, p. 1183-1188.

Research output: Contribution to journalArticle

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title = "Exploring the Life-Saving Potential of Naloxone: A Systematic Review and Descriptive Meta-Analysis of Take Home Naloxone (THN) Programmes for Opioid Users",
abstract = "BackgroundThe epidemic of drug-related mortality continues to endure. The most common cause of death associated with drugs is overdose and opioids are consistently the substances most prominently involved. As well as efforts to control the availability of illicit drugs and increase engagement in treatment services, the use of naloxone for peer administration has increasingly been championed as a mechanism for addressing the DRD epidemic. Despite increasing adoption and use of take-home naloxone (THN) as a primary response to DRD internationally the evidence base remains limited.Methods A systematic review and descriptive meta-analysis of the international THN literature was undertaken to determine an effect size for THN programmes. For each study, a Proportion of Use (PoU) was calculated using the number of ‘peer administered uses’ and the ‘total number of participant/clients’ trained and supplied with naloxone with a specific focus on people who use drugs (PWUD). This was constrained to a three month period as the lowest common denominator. As a percentage this gives the three month rate of use (per 100 participants). Results From twenty-five identified THN evaluations, nine studies allowed a PoU to be determined. Overall, the model shows a range of 5.2 to 13.1 (point estimate 9.2) naloxone uses every three months for every 100 PWUD trained. ConclusionOur model estimates that around 9{\%} of naloxone kits distributed are likely to be used for peer administration within the first three months of supply for every 100 PWUD trained. Future evaluations should directly compare different training structures to test relative effectiveness and use a series of fixed time periods (3, 6 and 12 months) to determine whether time since training affects rate of naloxone use.",
keywords = "Take-home naloxone, drugs, opioid, mortality, overdose",
author = "Andrew McAuley and Lorna Aucott and Catriona Matheson",
note = "Date of Acceptance: 21/09/2015 This study was funded by NHS Health Scotland. The opinions expressed in this paper as those of the authors alone and are not necessarily those of NHS Health Scotland. The funders had no role in the conduct of the research.",
year = "2015",
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AU - Aucott, Lorna

AU - Matheson, Catriona

N1 - Date of Acceptance: 21/09/2015 This study was funded by NHS Health Scotland. The opinions expressed in this paper as those of the authors alone and are not necessarily those of NHS Health Scotland. The funders had no role in the conduct of the research.

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N2 - BackgroundThe epidemic of drug-related mortality continues to endure. The most common cause of death associated with drugs is overdose and opioids are consistently the substances most prominently involved. As well as efforts to control the availability of illicit drugs and increase engagement in treatment services, the use of naloxone for peer administration has increasingly been championed as a mechanism for addressing the DRD epidemic. Despite increasing adoption and use of take-home naloxone (THN) as a primary response to DRD internationally the evidence base remains limited.Methods A systematic review and descriptive meta-analysis of the international THN literature was undertaken to determine an effect size for THN programmes. For each study, a Proportion of Use (PoU) was calculated using the number of ‘peer administered uses’ and the ‘total number of participant/clients’ trained and supplied with naloxone with a specific focus on people who use drugs (PWUD). This was constrained to a three month period as the lowest common denominator. As a percentage this gives the three month rate of use (per 100 participants). Results From twenty-five identified THN evaluations, nine studies allowed a PoU to be determined. Overall, the model shows a range of 5.2 to 13.1 (point estimate 9.2) naloxone uses every three months for every 100 PWUD trained. ConclusionOur model estimates that around 9% of naloxone kits distributed are likely to be used for peer administration within the first three months of supply for every 100 PWUD trained. Future evaluations should directly compare different training structures to test relative effectiveness and use a series of fixed time periods (3, 6 and 12 months) to determine whether time since training affects rate of naloxone use.

AB - BackgroundThe epidemic of drug-related mortality continues to endure. The most common cause of death associated with drugs is overdose and opioids are consistently the substances most prominently involved. As well as efforts to control the availability of illicit drugs and increase engagement in treatment services, the use of naloxone for peer administration has increasingly been championed as a mechanism for addressing the DRD epidemic. Despite increasing adoption and use of take-home naloxone (THN) as a primary response to DRD internationally the evidence base remains limited.Methods A systematic review and descriptive meta-analysis of the international THN literature was undertaken to determine an effect size for THN programmes. For each study, a Proportion of Use (PoU) was calculated using the number of ‘peer administered uses’ and the ‘total number of participant/clients’ trained and supplied with naloxone with a specific focus on people who use drugs (PWUD). This was constrained to a three month period as the lowest common denominator. As a percentage this gives the three month rate of use (per 100 participants). Results From twenty-five identified THN evaluations, nine studies allowed a PoU to be determined. Overall, the model shows a range of 5.2 to 13.1 (point estimate 9.2) naloxone uses every three months for every 100 PWUD trained. ConclusionOur model estimates that around 9% of naloxone kits distributed are likely to be used for peer administration within the first three months of supply for every 100 PWUD trained. Future evaluations should directly compare different training structures to test relative effectiveness and use a series of fixed time periods (3, 6 and 12 months) to determine whether time since training affects rate of naloxone use.

KW - Take-home naloxone

KW - drugs

KW - opioid

KW - mortality

KW - overdose

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JO - International Journal of Drug Policy

JF - International Journal of Drug Policy

SN - 0955-3959

IS - 12

ER -